Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 23;10(1):15499.
doi: 10.1038/s41598-020-72647-7.

Survival curve identifies critical period for postoperative mortality in cardiac patients undergoing emergency general surgery

Diego Ramos Martines  1 , Fernanda Nii  1 , Kayo Augusto de Almeida Medeiros  1 , Bárbara Justo Carvalho  1 , Leonardo Zumerkorn Pipek  1 , Gustavo Heluani Antunes de Mesquita  1 , Leandro Ryuchi Iuamoto  1 , Gustavo B F Oliveira  2 , Antonio Carlos Mugayar Bianco  2 , Alberto Meyer  3   4
Affiliations

Survival curve identifies critical period for postoperative mortality in cardiac patients undergoing emergency general surgery

Diego Ramos Martines et al. Sci Rep. .

Abstract

The number of non-cardiac major surgeries carried out has significantly increased in recent years to around 200 million procedures carried out annually. Approximately 30% of patients submitted to non-cardiac surgery present some form of cardiovascular comorbidity. In emergency situations, with less surgery planning time and greater clinical severity, the risks become even more significant. The aim of this study is to determine the incidence and clinical outcomes in patients with cardiovascular disease submitted to non-cardiac surgical procedures in a single cardiovascular referral center. This is a prospective cohort study of patients with cardiovascular disease submitted to non-cardiovascular surgery. All procedures were carried out by the same surgeon, between January 2006 and January 2018. 240 patients included were elderly, 154 were male (64%), 8 patients presented two diagnoses. Of the resulting 248 procedures carried out, 230 were emergency (92.8%). From the data obtained it was possible to estimate the day from which the occurrence of mortality is less probable in the postoperative phase. Our research evaluated the epidemiological profile of the surgeries and we were able to estimate the survival and delimit the period of greatest risk of mortality in these patients. The high rate of acute mesenteric ischemia was notable, a serious and frequently fatal condition.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
30-day survival curve in patients with the most common diagnoses and comparison with treatment for other diagnoses. (A) Acute mesenteric ischemia. (B) Acute cholecystitis. (C) Acute appendicitis. (D) Fournier. (E) Emergent hernia. (F) Perforated peptic ulcer. (G) Colon neoplasia. (H) Elective hernia. (I) Overall mortality comparison between sex.
Figure 2
Figure 2
30 day survival curve in patients with the most common diagnoses.
See this image and copyright information in PMC

References

    1. Devereaux PJ, Sessler DI. Cardiac complications in patients undergoing major noncardiac surgery. N. Engl. J. Med. 2015;373(23):2258–2269. doi: 10.1056/NEJMra1502824. - DOI - PubMed
    1. Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, De Hert S, Ford I, Gonzalez Juanatey JR, Gorenek B, Heyndrickx GR, Hoeft A, Huber K, Iung B, Kjeldsen KP, Longrois D, Luescher TF, Pierard L, Pocock S, Price S, Roffi M, Sirnes PA, Uva MS, Voudris V, Funck-Brentano C, Authors/Task Force Members 2014 ESC/ESA Guidelines on non-cardiac surgery: Cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: Cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA) Eur J Anaesthesiol. 2014;31(10):517–573. doi: 10.1097/EJA.0000000000000150. - DOI - PubMed
    1. Smilowitz NR, Gupta N, Guo Y, Berger JS, Bangalore S. Perioperative acute myocardial infarction associated with non-cardiac surgery. Eur. Heart J. 2017;38(31):2409–2417. doi: 10.1093/eurheartj/ehx313. - DOI - PubMed
    1. de Nadal M, Pérez-Hoyos S, Montejo-González JC, Pearse R, Aldecoa C. European surgical outcomes study (EuSOS) in Spain Intensive care admission and hospital mortality in the elderly after non-cardiac surgery. Med. Intens. 2018;42(8):463–472. doi: 10.1016/j.medin.2018.01.009. - DOI - PubMed
    1. Kaw R, Nagarajan V, Jaikumar L, Halkar M, Mohananey D, Hernandez AV, Ramakrishna H, Wijeysundera D. Predictive value of stress testing, revised cardiac risk index, and functional status in patients undergoing noncardiac surgery. J. Cardiothorac. Vasc. Anesth. 2019;33(4):927–932. doi: 10.1053/j.jvca.2018.07.020. - DOI - PubMed